Out with the old in with the new! 

Physiotherapists and orthopaedic medical professionals whom have kept on the cutting edge of research advances will have largely moved away from many of the electrotherapeutic modalities of the 90’s such as ultrasound (sound waves) and shortwave. However, a relatively new therapy, inspired by lithotripsy (the process of breaking down kidney stones) has shot to fame. 

Shockwave therapy, first focused, now radial has been showing incredibly promising results for pain conditions and tendon dysfunction. Much of the research has been focused around tendon issues such as:

  • Lateral Epicondilitis (Tennis Elbow) 

  • Achilles Tendinopathy (Joggers Heel / Heel Pain) 

  • Plantar Fasciitis/Fasciopathy 

  • Insertional Hamstring Tendinopathies

Moreover, many of the leading proponents of shockwave therapy such as Dr Ulrich Dreiskliker have been advocating radial shockwave for trigger points therapy. 

No other non-surgical orthopaedic treatment has had so many independently validated studies published as ESWT. 

What is it?

ESWT/RSWT is a non-invasive shockwave treatment that involves creating a series of low energy acoustic wave pulsations that are directly applied to an injury through a person’s skin via a gel medium to provide fast relief of pain and mobility restoration.

How it Works 

Pain Relief

  1. Shockwaves cause increased blood circulation and angiogenesis (formation of new vessels). This leads to a reduction in concentration of chemicals that sensitise structures to pain. 

  2. It is suggested that repeated applications of shockwaves actually help prevent certain slow pain pathways (C-fibres) releasing substance P, therefore reducing pain. 

  3. The stimulation of of mesenchymal stem cells induced by the shockwave treatment to increase in number and differentiate to the appropriate tissue. 

  4. Nitric oxide which is a vessel dilating gas and pain inhibitor is also released by shockwaves 

For Tissue Regeneration 

  1. New collagen fibres form due to the release of various growth factors such as VEGF. 

  2. Improved cellular proliferation (growth) and collagen synthesis to with a penetration depth of 2-3cm with radial shockwave.  

And a bonus….

Studies have also shown that Radial Shockwave therapy is one of the only forms of therapy that has good evidence for reducing cellulite! 

Benefits

Benefits of Shockwave Therapy treatment:

  • Cost efficient

  • Non-invasive

  • No anaesthesia or painkillers required - in fact using anaesthetics with shockwave therapy has been shown to reduce its effectiveness. 

  • Minimal risks of side effects

  • Helps reduce chronic and acute pain (eg: heel pain)

Is it painful?

Depending on the structure involved, shockwave therapy can be temporarily uncomfortable but the specialist working with you will work hard at making it as comfortable as possible. The procedure only lasts for a few minutes and post shockwave treatment soreness around the treated area can last for 1-2 days much like a deep tissue massage. During this period it is important not to take anti-inflammatories as this soreness normally represents inflammation which is the body’s healing process!